| Vita Wellness Llc | |
|
2117 N Kelly Ave Edmond OK 73003-3908 | |
| (405) 726-2701 | |
| (405) 726-2702 |
| Full Name | Vita Wellness Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2117 N Kelly Ave, Edmond, Oklahoma |
| Authorized Official Name and Position | Todd Anthony Krehbiel (OWNER) |
| Authorized Official Contact | 4057262701 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vita Wellness Llc 2117 N Kelly Ave Edmond OK 73003-3908 Ph: (405) 726-2701 | Vita Wellness Llc 2117 N Kelly Ave Edmond OK 73003-3908 Ph: (405) 726-2701 |
| NPI Number | 1497261952 |
|---|---|
| Provider Enumeration Date | 12/20/2017 |
| Last Update Date | 12/20/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497261952 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 18489 (Oklahoma) | Primary |
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